'Superbugs making gonorrhoea hard to treat'

The data, evaluated through two latest studies published in international journal PLOS, shows an estimated 78 million people globally are infected with gonorrhea each year.Sushmi Dey | TNN | July 08, 2017, 07:42 IST

NEW DELHI: Antibiotic resistance is making gonorrhoea - a common sexually-transmitted infection - much harder, and sometimes impossible, to treat, the World Health Organisation (WHO) has reported based on data from 77 countries. India is witnessing an alarming rise in antibiotic resistance, much of which has been triggered by over-prescription of the drugs by doctors and irrational over-the counter sale of antibiotics.

The data, evaluated through two latest studies published in international journal PLOS, shows an estimated 78 million people globally are infected with gonorrhea each year. However, this is likely to be an underestimation because only those countries - particularly high-income ones, where surveillance is best - are finding cases of the infection that are untreatable by all known antibiotics.

"These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common," said Dr Teodora Wi, medical officer, human reproduction, at WHO.

"The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them," he added.

According to WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP), which monitors trends in drug-resistant gonorrhea, widespread resistance to ciprofloxacin was found during 2009 to 2014 (97% of countries that reported data in that period found drug-resistant strains), 81% countries reported resistance to azithromycin, and the emergence of resistance to the current last-resort treatment: the extended-spectrum cephalosporins (ESCs) oral cefixime or injectable ceftriaxone was 66%.

In India, though the disease burden is not very high, the alarming rate of anti-microbial resistance is a threat to treatment. India has already developed more than 50% resistance to ciprofloxacin. As a result, the drug has been taken off the treatment protocol and is not used any more for the disease. While combinations of cefixime and azithromycin are still in use in the country, experts fear irrational use can lead to resistance.

"Though the burden of gonococcal infection is currently not very high in India, we are more concerned about the problem of antibiotic resistance which can lead to a treatment crisis. There is an urgent need for caution againt the irrational use of antibiotics," says Dr Manju Bala, consultant and professor of microbiology at Apex STI Centre in Safdarjung Hospital.

Th e government has already initiated several steps to contain antibiotic resistance. Gonorrhoea can infect the genitals, rectum, and throat. Complications from gonorrhoea affect women more, including pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV.